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Tuesday, May 29, 2007

Whew! It was a long holiday weekend and I enjoyed some much needed time offline (two whole days, can you even imagine?!) That said, it also means that I missed out on posting a TON of Lactivist related news, so here we go with a rapid fire approach to the latest and greatest breastfeeding news...

There is a second probable contributor to the problem and that's the increased rate of nursing and increased rate of duration of nursing in American populations. So over the past 30 years for very good reasons, for the health of infants, more and more mothers are nursing their babies. We have gone from a nursing rate of about 25 percent roughly a quarter of babies being nursed by their mothers to about 75 percent. The average duration that mothers nurse their infants now is about twice as great as it was 30 years ago. This is a positive and good and healthy thing. The problem is that these chemicals are concentrated in breast milk at a level of about six fold as they are in regular body tissues. Because they are concentrated in fat, in a sense the mother is concentrating these poisons and delivering them in relatively high dose levels to infants.

What I'll find interesting is to see how it will get spun if it makes the mainstream news... Will it be that women should avoid breastfeeding because of this, or that the risks of formula still outweigh the risks of these chemicals, or that we need to clear these chemicals from the environment? (Thanks to Aruni for this one.)

Researchers have found that an effective vaccine, provided shortly after birth, would not only protect an infant from contracting HIV while breast-feeding but also could offer long-term or even life-long immunity from the virus, according to the Glaser Foundation. The protective vaccine then would allow HIV-positive mothers to safely breast-feed for an extended period of time, providing infants in resource-poor settings with nutritional and basic health benefits.

Wow! Absolutely outstanding! While here in the United States, passing up breastfeeding for the relative safety of formula isn't always a tough call for HIV positive mothers, it's a life or death choice in third world nations that lack clean water supplies. The idea that medical advances are being made that would allow mothers to breastfeed without fear of passing HIV is just wonderful. Kudos to Bill Gates for funding this type of research!

The Food and Drug Administration backed continuous use of the pill, Lybrel, which is manufactured by Wyeth. Taken daily it can halt a woman's menstrual periods indefinitely, as well as prevent pregnancies. But it may be difficult for the women to recognise if they have become pregnant because Lybrel users will not have regular periods.

Not being a fan of hormonal birth control, (I still blame it for sending my body into anti-ovulation insanity which necessitated fertility drugs for me to get pregnant with Elnora) I wouldn't be tempted by this...but if I was, the section that notes that HALF of the women in the drug trials dropped out "citing irregular and unscheduled bleeding" would have been enough to make me think twice. (Thanks Melissa!)

A simple method of flash-heating breast milk infected with HIV successfully inactivated the free-floating virus, according to a new study led by researchers at the Berkeley and Davis campuses of the University of California. Notably, the technique - heating a glass jar of expressed breast milk in a pan of water over a flame or single burner - can be easily applied in the homes of mothers in resource-poor communities.

Wow, more great news on the breastfeeding and HIV front. It is estimated that more than 40% of the 700K children who get infected with HIV each year have contracted it from extended breastfeeding. As I mentioned above, breast or formula is not an easy choice in countries where children die from simple cases of diarrhea. This simple method could mean a huge life and death difference in the developing world. (Thanks Julia!)

Ten midwives might bring in a caseload equal to that of two obstetricians. But their patient-centered personal care, including 45-minute appointments and continuous emotional support, also means clients tend to leave hospital more quickly, require fewer medical interventions, and receive attentive prenatal and postnatal care. All of which translate to lower costs for the health care system. They are also the only regulated professionals to accommodate home births.

The article states that 40% of women who wish to use midwives are unable to due to lack of availability. Ahh...how I dream of the day that I read an article and see attitudes about midwifery like that here in Ohio! In fact, there's a movement afoot right now in the Ohio legislature to make home birth midwifery illegal, but I'll cover more of that in an upcoming post. (Thanks for sending this Judy!)

Are the chemical poisons refering to the ones in the environment or the ones that are released from your body fat as you lose weight after pregnancy?

The breastfeeding research and new options for HIV positive mothers are wonderful.

Also, I think that a lot of insurance companies in the US do not cover midwives or doulas. That could be a major contributor to the reason that more women aren't using them.

I've had the same OB/GYN for 5 years, since I moved here. I adore her. I found out after my last pregnancy, when I was looking over my insurance, that not only do they not cover 'voluntary sterilization' procedures but they refuse to cover midwives and anything that would go along with a non-hospital birth.

I was a little more upset that they didn't cover me getting my tubes tied than I was about the midwife thing, at the time. I had 3 children in 3 years and the other birth controls we were using were not working. I talked to my OB/GYN about an IUD and she said that she didn't do those because she believed they were abortions by her understanding of how they worked.

So anyway, in all of this rambling, it irritates me that insurance companies can pretty much dictate to people what type of health care they need/don't need. I mean, people pay thousands of dollars into their insurance companies each year and often don't even meet the deductibles set, so the insurance companies wind up not having to pay out for them.

As far as I understand it, the chemical toxins are absorbed into our sytem over the course of our lifetimes and build up in our fat reserves. Since moms that have had babies often have higher fat reserves and much of that fat is burned off to create milk, higher levels of the chemicals are passing through breast milk.

To my understanding, this is only an issue in certain areas of the country and even then, there's nothing yet stating whether the risk of those chemicals outweighs all the benefits of breast milk.

As for the health insurance, I'll never understand the logic there. Yes, OBs are a powerful lobbying force, but home birth is CHEAP!

My hospital birth with Elnora cost the insurance company around 9K and us around $1500. My home birth with Emmitt cost my insurance company about $700 and cost us about $800. How can a company obsessed with the bottom line not back that?

Well, the thing is that a breast pump likely costs far less than formula does in the grand scheme of things...

Plus many moms ARE able to manually express milk. Heck, when Emmitt was a month old, I could hand express five ounces from one side in about 7 or 8 minutes. (PLEASE don't throw things at me Judy...I'm sorry, really I am.)

My concern is more about sterilization. Sure, they can buy glass jars and they can heat water, but do they have the supplies to properly clean those glass jars? They have a tainted water supply, right?

Again, not saying that this doesn't open up great potential, just not sure how it would all work.

Re: Midwives in Ohio, I've got the email with the info, just need to get a post put together.

Re: Chemicals in breast milk, this story reminded me of a NYT article from way back in Jan 2005 http://www.nytimes.com/2005/01/09/magazine/09TOXIC.html?pagewanted=1&ei=5070&en=88c32484bae793c8&ex=1180670400Called "Toxic Breast Milk?" (I dont think the link requires a NYT subscription, but if it does, feel free to delete this comment). Its a long-ish article (5pgs) about PCBs and PBDEs in breast milk, and it has a happy ending. At least based on what was known 2 years ago, it is still better to breastfeed, even with "contaminated" milk (though the article *will* make you want to throw out anything plastic in your house. sigh...)

Another thought I had is that unless you are using bottled water to mix the formula, which can get very expensive, then plenty of toxins (e.g., chlorine) get into the formula as well. And I recently read about fluorosis in formula fed babies since both tap water and formula have fluoride added, and by not using bottled water, babies are getting too much flouride.

Currently a group called Partners in Health is working with the Clinton HIV/AIDS initiative to provide formula and safe ways to prepare it to HIV positive mothers in Rwaanda. From what I have heard, their program has been successful and there has not been significant infant mortality due to formula feeding. If they can do this without significant diarrheal mortality, then they could certainly implement a program teaching HIV positive mothers to flash heat breast milk. This would almost certainly be healthier, cheaper, and better, so I would say that with responsible programs in place, this new finding could really do something for maternal-child transmission and infant health in Africa.

Concerning the chemical article, if it were to be used to favor formula over breastmilk then you'd have to assume that none of these or other harmful chemicals are present in baby formula, which isn't true. Baby formula is packed in plastic lined steel containers or plastic bottles for the most part, so some chemicals have to leech into the formula, and it's usually fed from a plastic bottle.

It's just a sad fact of modern life that you can hope to minimize but not eliminate.

I wanted to make a clarification about the legal status of midwives in Ohio and in other states without licensure. Without a statute defining the practice of DEM, exempting it from the medical/nursing practice acts and giving regulatory authority to a civil administrative agency (as opposed to the criminal courts, which currently have jurisdiction over them) midwives in those states are subject to prosecution for practicing medicine/nursing without a license.

In addition, midwives who use pharmaceutical drugs to treat PPH are violating federal and state statutes governing the possession and use of controlled substances. And midwives in unlicensed states who have a death or injury in their practice are additionally subject to other criminal charges, such as manslaughter or reckless endangerment (to mention the two most common charges besides practicing medicine without a license).

While it's possible the OH legislature would try to introduce a bill prohibiting specific midwifery practices (as recently happened in ND) it's simply icing on the cake and does nothing to change the current legal status of midwives there.

Not that you shouldn't fight such a bill! In fact, it would be a good opportunity to flex grassroots muscle and reintroduce your midwifery licensing bill as a better alternative.

Thanks for the mention! I also recently ran across another article on what they call gender-bending pollutants. This article on the washingtonpost.com suggests that in general in the US and Japan there are less boys being born than girls. You can see information on our blog at: http://babblesoft.wordpress.com/2007/06/06/fathers-of-the-future-how-many-dads-will-there-be/